A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
Early treatment can reduce the brain damage and potential complications. Strokes can be treated and prevented.
Types
The following are the types of strokes one can suffer from:
- Ischemic stroke: when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:
– Thrombotic stroke: Occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain
– Embolic stroke: Occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries - Haemorrhagic stroke: Occurs when a blood vessel in your brain leaks or ruptures. Types of haemorrhagic stroke include:
– Intracerebral haemorrhage: A blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and are also damaged
– Subarachnoid haemorrhage: An artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signalled by a sudden, severe headache
– Transient ischemic attack (TIA): sometimes known as a mini-stroke, occurs when a clot or debris blocks blood flow to part of your nervous system — but there is no permanent tissue damage and no lasting symptoms
Symptoms
One needs to pay attention to the following symptoms:
· Trouble with speaking and understanding
· Paralysis or numbness of the face, arm or leg
· Trouble with seeing in one or both eyes
· Headache
· Trouble with walking
Causes
A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (haemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn’t cause permanent damage.
Brain haemorrhages can result from many conditions that affect your blood vessels. These include:
– Uncontrolled high blood pressure (hypertension)
– Overtreatment with anticoagulants (blood thinners)
– Weak spots in your blood vessel walls (aneurysms)
Prevention
Adopting a healthy lifestyle is a great step to preventing a stroke, recommendations include:
· Controlling high blood pressure (hypertension)
· Lowering the amount of cholesterol and saturated fat in your diet
· Quitting tobacco use
· Controlling diabetes
· Maintaining a healthy weight
· Eating a diet rich in fruits and vegetables
· Exercising regularly
· Drinking alcohol in moderation, if at all.
· Treating obstructive sleep apnoea (OSA)
· Avoiding illegal drugs
Preventative medications include:
· Anti-platelet drugs
· Anticoagulants
Treatment
Treatment options depend on a number of factors. This includes what kind of stroke it was and how long it lasted. Treatment for TIA includes taking medications that will help prevent future strokes. These medications include antiplatelet and anticoagulants to prevent blood clotting.
Ischemic stroke treatments include a medication known as plasminogen activator (tPA), delivered through an IV to dissolve the clot. If this is not suitable, doctors perform procedures to remove the clot of deliver clot-busting medications to the brain.
Haemorrhagic stroke treatments involve trying to stop bleeding in your brain and reduce the side effects associated with brain bleeding. Surgical procedures include surgical clipping or coiling which are designed to keep the blood vessel from bleeding further. You may need medication to reduce intracranial pressure and require transfusions to increase the amount of blood-clotting materials in your blood to try to stop bleeding.
Complications and risk factors
Risk factors
Lifestyle risk factors:
o Being overweight or obese
o Physical inactivity
o Heavy or binge drinking
o Use of illicit drugs such as cocaine and methamphetamines
Medical risk factors:
o Blood pressure readings higher than 120/80 millimetres of mercury (mm Hg)
o Cigarette smoking or exposure to second hand smoke
o High cholesterol
o Diabetes
o Obstructive sleep apnoea
o Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm
o Personal or family history of stroke, heart attack or transient ischemic attack
· Other factors:
o Age —People age 55 or older have a higher risk of stroke than do younger people
o Race — Africans have a higher risk of stroke than do people of other races
o Sex — Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they’re more likely to die of strokes than are men
o Hormones — use of birth control pills or hormone therapies that include oestrogen, as well as increased oestrogen levels from pregnancy and childbirth
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected.
Complications may include:
· Paralysis or loss of muscle movement
· Difficulty talking or swallowing
· Memory loss or thinking difficulties
· Emotional problems
· Pain
· Changes in behaviour and self-care abilit
When to see a doctor
Seek immediate medical attention if you notice symptoms of a stroke, even if they seem to fluctuate or disappear. Think “FAST” and do the following:
· Face. Ask the person to smile. Does one side of the face droop
· Arms. Ask the person to raise both arms. Does one arm drift downward or is one arm unable to rise up
· Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange
· Time. If you observe any of these signs, call an emergency service
The longer a stroke goes untreated, the greater the potential for brain damage and disability.
Contact 031 560 5500 or www.netcare.co.za
